肿瘤调强适形放疗的质量控制

目的探讨肿瘤调强适形放疗质量控制的方法。方法通过完善切合实际的临床质控制度、成立科主任为首的质量控制小组、建立调强适形放疗精度验证和剂量验证队伍、加强适形放疗流程的环节管理、制订单病种肿瘤调强适形放疗的规范、重视放射治疗设备和放射治疗物理技术的质量控制以及加强放射治疗员工培训等工作开展质量控制。结果发展成为拥有三台进口加速器的地级市放疗中心,近1万张胶片精度验证,头颈部肿瘤摆位误差为（1.8±0.6）mm,胸部肿瘤摆位误差为（2.4±0.8）mm,腹部肿瘤的摆位误差为（2.6±0.9）mm,剂量验证的首次通过率为98.0%,二次剂量验证通过率近100%,单病种放疗疗效达到国内大型放疗中心同等水平。结论在肿瘤调强适形放疗中进行精度验证和剂量验证、加强环节管理、重视放射治疗设备和物理技术等的全面质量控制是切实可行和有效的,值得推广应用。     

降低头颈部调强放射治疗摆位误差的探讨

目的 探讨降低头颈部调强放射治疗摆位误差的措施,提高调强放疗的质量.方法 选择头颈部调强放射治疗患者26例,利用头颈肩底板和头颈肩面膜进行体位的精确固定,通过技术员细心规范的摆位,以及首次治疗前对患者进行机载锥形束CT(CBCT)扫描,治疗过程中每周至少1次CBCT扫描,取得左右、头脚、腹背3个方向的误差数值,进行判断和在线纠正摆位误差.结果 26例患者进行122例次CBCT扫描位置验证,其中首次摆位26例次,治疗过程中96例次,治疗过程中摆位误差数值减小,治疗体位重复率高.所有患者能顺利完成放疗计划,肿瘤局控率97.2％,完全缓解81.4％,不良反应明显下降.结论 通过质量控制,技术改进,可以保证治疗体位的重复性,使摆位误差降到最小,达到调强放疗的目的.     

适形调强放射治疗精确摆位方法及体会

目的总结我科54例接受适形调强放射治疗患者摆位的经验,以期提高摆位精度。方法采用适形调强治疗,全部采用等中心激光灯摆位和热塑网膜加体架固定,通过电子射野影像装置的验证,分析治疗中心在X,Y,Z轴方向上的误差。结果治疗中心在X,Y,Z轴方向上的误差均小于临床靶区（CTV）到计划靶区（PTV）之间的距离,满足适形调强治疗的临床要求。结论通过及时进行电子影像监测和改进放射治疗技术,可以提高适形调强放射治疗摆位精确性。     

鼻咽癌适形调强放疗疗效观察

目的 分析鼻咽癌适形调强放疗的疗效.方法 选取本院152例鼻咽癌患者,选用动态或者经典的适形调强放疗技术对患者进行治疗.结果 患者的治疗总有效率是90.79％.肿瘤局部控制率1年为99.3％,2年为97.4％,5年为93.4％.鼻咽癌患者适形调强放疗治疗后的生存期1年占99.3％,2年占91.5％,5年占84.2％.患者出现急性反应多在1～3级,出现4级的情况较少.结论 鼻咽癌患者应用适形调强放疗能降低急性反应、剂量分布正确合理,对肿瘤局部有良好的控制率,是目前临床中较为理想的鼻咽癌放射治疗方法.     

图像引导放疗技术对提高鼻咽癌放疗精度的研究

目的 探讨图像引导放疗技术对鼻咽癌调强放疗患者摆位误差的影响.方法 应用Elekta Synergy(TM)IGRT加速器机载千伏级锥形束CT(KV-CBCT)对鼻咽癌调强适形放疗患者每次治疗时,分别于校正前后各扫描1次CBCT,共校正72次,获得144组XVI数据,分析校正前后摆位误差的变化情况.结果 测量得出系统误...     

鼻咽癌常规放射治疗解析

目的 探讨鼻咽癌常规放射治疗的各种治疗方法和摆位方法.方法 通过比较鼻咽癌各种治疗技术和摆位方法的优缺点,找到最优的治疗方法.结果 3D适形放疗具有高精度,靶区剂量分布更均匀,摆位误差更小的优点,结论 采用3D适形放射治疗是最佳的治疗方法.     

鼻咽癌调强放疗与适形放疗的疗效和副反应比较研究

目的：比较鼻咽癌患者调强放疗与适形放疗的疗效和副反应,以及对预后和生存质量的影响。方法2005年1月至2007年10月,我院共186例初诊且无远处转移的鼻咽癌患者接受全程放射治疗,调强放疗组89例,适形放疗组97例,两组病例均采用Phicips高能直线加速器治疗,选择能量为6MV-X射线。适形放疗组分4段设野,DT2Gy/次,1次/d ,5次/周,根治剂量DT70～72Gy/35～36次/7～8周,预防剂量DT50Gy/25次/5周。调强放疗采用7野共面照射,靶区处方剂量GTVnx ：69．96Gy～73．92Gy ,GTVnd：69．96Gy ,PTV1：60．06Gy ,PTV2：50．96Gy。全疗程33次,1次/d ,5次/周。放疗过程中每两周执行1次实时验证。结果两组病例均顺利完成全程放疗,适形放疗组5年局部控制率、总生存率分别为90．7％、85．5％;调强放疗组5年局部控制率、总生存率分别为91％、86．5％。调强放疗组口干和张口困难发生率和损伤程度明显低于适形放疗组。结论调强放疗组的副反应发生率和发生程度较适形放疗组明显降低,能提高鼻咽癌患者生活质量。     

鼻咽癌常规放疗与三维适形放疗摆位误差的对比分析

目的通过鼻咽癌常规放疗与适形放疗摆位误差的比较,找出摆位时存在的问题,并找出解决方法。方法以进行放射治疗的40例鼻咽癌患者为对象,20例患者接受常规外照射,另外20例行适形放疗,对其摆位误差进行分析。结果40例患者共拍摄120张射野验证片。常规放疗组摆位误差x轴（3．95±2．10）mm、Y轴（3．50±2．03）mm和Z轴（3．02±2．10）mm大于适形放疗组的x轴（1．78±1．03）mm、Y轴（1．53±0．92）mm和z轴（1．60±1．11）mm。结论通过严格的质量控制和采用适形放疗可以减少摆位误差,有效地提高摆位的雷傅忡．     

鼻咽癌放射治疗后遗症及防治措施

<正>目前鼻咽癌公认的有效根治性治疗手段为放射治疗或以放疗为主的综合治疗[1]。随着放疗设备的更新及放射治疗技术的不断改进,特别是调强适形放疗技术、图像引导放疗技术等精确放疗技术应用于临床以来,患者的生存率明显提高。但是放射治疗在治愈肿瘤的同时,不可避免地损伤正常组织和器官,严重影响患者的生活质量。鼻咽癌放疗时照射体     

乳腺癌调强放疗技术及质量控制

目的探讨乳腺癌调强放射治疗技术及其质量控制。方法选择31例保乳术后乳腺癌患者行三维适形调强放疗,PTV-GTV总剂量DT 60⁶3 Gy,1次/天,DT2.063 Gy,1次/天,DT2.0².1 Gy/次,5次/周。结果所有患者顺利完成全程放疗,放疗反应轻微,未出现放射性肺炎、心脏损伤等严重毒副反应。结论三维适形调强放疗保乳术后乳腺癌,治疗摆位过程严格质量控制程序,可确保治疗计划的精准实施。     

Readmissions for treatment for alcoholism

First admissions and readmissions for alcoholism have risen steeply in recent decades. This study looked at readmission histories for four cohorts of alcoholics first admitted to inpatient psychiatric treatment in 1967-68, 1973, 1977 or 1979. Over the twelve years the first cohort was observed, alcoholics on average spent 254 days in treatment and had 2.14 alcohol-related readmissions. However the distributions were very skewed: 50% stayed less than 92 days and 45.6% had no readmissions at all. All four cohorts yielded similar results over comparable time periods and all showed markedly skewed distributions reflecting the diversity of readmission histories among alcoholics. Policy decisions about alcoholism inpatient treatment must take account of this diversity.     

Projections for insulin treatment for diabetics

The evolution of insulin treatment of diabetes has dramatically changed the natural course of this disease. Modern recombinant DNA technology has brought about many new insulin analogues with improved pharmacokinetics, resulting in better glycemic control. In addition, improved insulin delivery systems, such as insulin pumps and pens, have been introduced to provide convenience and to enhance patient compliance. Efforts are currently being devoted to developing noninvasive insulin formulations, such as oral and pulmonary insulin. A number of products are at different stages of clinical trials. Meanwhile, the quest for a permanent cure for diabetes continues. The frontier of diabetes research has gone through a period of substantial expansion, with the emergence of new areas that include gene therapy, islet cell transplantation and diabetic vaccine. Technological breakthroughs, such as recombinant DNA, nanotechnology, microarray-aided genomics and proteomics, will provide more profound insights into the pathogenesis, and the immunological and biological basis of diabetes. Our growing knowledge in these areas will ultimately contribute to the discovery of preventive methods against or a cure for this disease.     

Control of craving for methamphetamine: development of scales for dependence and search for medicines for treatment]

Methamphetamine dependence presents a serious problem not only for patients but also for society. Medical treatment has mainly targeted psychotic symptoms such as hallucination and delusion, and ignored the symptoms of craving, which are the major cause of dependence. Therefore, the risk of lapse into methamphetamine reuse remains very high. Although development of both medicines and programs for treatment of craving is needed, progress has been hampered by the lack of appropriate scales for assessing the severity of dependence and craving. On the other hand, recent breakthroughs in genomic sciences and molecular medicine have made it possible to investigate the molecular mechanisms underlying craving in animals. This paper reviews studies on the development of scales for assessing the severity of methamphetamine dependence and craving, together with recent data on candidate medicines for craving treatment in animals. The reliability and validity of the revised Addiction Severity Index -Japanese version (ASI-J) was confirmed after its administration to 100 drug abuse patients. The Craving Index was also newly developed, and its validity for prediction of relapse was confirmed. In animal experiments, fluoxetine, a selective serotonin reuptake inhibitor, was recognized as a candidate medicine for treatment of methamphetamine dependence.